Individual
MISS AMANDA BETH FISCOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
281 WAINWRIGHT AVE # 1, SYRACUSE, NY 13208-3155
(315) 455-7857
Mailing address
281 WAINWRIGHT AVE # 1, SYRACUSE, NY 13208-3155
(315) 455-7857
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
5440771
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02838599
—
NY
Enumeration date
02/07/2007
Last updated
07/08/2007
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